You are here

Home » Content

Kronik Böbrek Yetmezlikli Hastalarda Statinlerin Pleiotropik Etkilerinin Değerlendirilmesi

Evaluation of Pleiotropic Effects of Statins in Chronic Renal Failure Patients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
10.5262/tndt.2011.1002.06

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
ObjectI ves : Atherosclerosis is seen more frequently in patients with chronic renal failure (CRF) due to the oxidative stress, chronic inflammation and endothelial dysfunction. Besides lowering total and low density lipoprotein (LDL) cholesterol levels, statins also lower the frequency of cardiovascular incidents in patients with chronic renal failure by their pleiotropic effects. We aimed to investigate whether atorvastatin had pleiotropic effects in dialysis patients. MA TERIAL and metho ds: 21 hyperlipidemic dialysis patients (12 on hemodialysis and 9 peritoneal dialysis) with LDL cholesterol levels over 130 mg/dl were included in this study. Atorvastatin was titrated and given to patients for 6 months. After LDL cholesterol level were reduced to under 100mg/day, we evaluated oxidized LDL, malondialdehyde (MDA), interleukin-6 (IL-6), high sensitive C reactive protein (hsCRP), fibrinogen, platelet count, sedimentation rate, nitric oxide (NO), Von Willebrand factor antigen (vWF ag), factor VIII (FVIII) and homocysteine. Res ults : Significant reductions were obtained in total cholesterol, LDL-cholesterol (p<0.001), triglyceride (p<0.05), oxidized LDL (p<0.001), sedimentation value (p<0.01) and platelet count (p<0.05) with atorvastatin treatment. No differences were seen in the other parameters. ConclusIo n: Atorvastatin is associated with significant improvement of lipid profile and reduction of ox-LDL, platelet count, and sedimentation in dialysis patients.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Kronik böbrek yetmezlikli hastalarda oksidatif stres, kronik inflamasyon ve endotel işlev bozukluğudan dolayı aterosklerozis daha sık görülür. Kronik böbrek yetmezlikli hastalarda statinler, toplam ve düşük dansiteli lipoprotein (LDL) kolesterolü düşürücü etkilerinin yanında pleiotropik etkileri ile kardiyovasküler olay sıklığını azaltırlar. Biz diyaliz hastalarında statinlerin pleiotropik etkilerinin olup olmadığını araştırmayı amaçladık. GEREÇ ve YÖN TEML ER: Çalışmaya LDL kolesterol düzeyi 130 mg/dl’den yüksek olan 21 diyaliz hastası (12 hemodiyaliz, 9 periton diyalizi) alındı. Atorvastatin titre edilerek 6 ay süreyle verildi. LDL kolesterol düzeyi 100 mg/dl altına indikten sonra oksidize LDL, malondialdehid (MDA), interleukin 6 (IL-6), yüksek duyarlıklı C reaktif protein (ydCRP), fibrinojen, platelet sayısı, sedimentasyon hızı, nitrik oksid (NO), Von Willebrand faktör antijeni (vWF ag), faktör VIII (FVIII) ve homosistein düzeylerini değerlendirdik. BUL GULA R: Atorvastatin tedavisi ile total kolesterol, LDL kolesterol (p<0,001), trigliserid (p<0,05), oksidize LDL (p<0,001), sedimentasyon hızı (p<0,01) ve trombosit sayısında (p<0,05) anlamlı düşme gözlendi. Diğer göstergelerde anlamlı farklılık yoktu. SONU Ç: Atorvastatin diyaliz hastalarında lipid profilinde önemli iyileşme ile oksidize LDL, trombosit sayısı ve sedimentasyon hızında azalma sağlamaktadır.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_20_pp_150-155.pdf
  • 2
150-155
  • Turkish

REFERENCES

References: 

. Annuk M, Zilmer M, Fellström B: Endothelium-dependent
vasodilation and oxidative stress in chronic renal failure: Impact on
cardiovascular disease. Kidney Int 2003; 84: 50-53
2. Foley RN, Parfrey PS: Cardiovascular disease and mortality in
ESRD. J Nephrol 1998; 11(5): 239-245
3. Cases A, Vera M, Lopez Gomez JM: Cardiovascular risk in patient
with chronic renal failure. Patients in renal replacement therapy.
Nefrologia 2002; 22: 68-74
4. Stenvinkel P: Interactions between inflammation, oxidative stress
and endothelial dysfunction in end-stage renal disease. J Ren Nutr
2003; 13(2): 144-148
5. Oygar D: Hemodiyaliz tedavisi gören hastalarda iskemik kalp
hastalığı, kalp yetmezliği ve perikarditin tedavisi. İçinde:
Süleymanlar G, Erek E (ed). Diyaliz Tedavisi. Ankara. Güneş
Kitabevi, 2004; 353-358
6. Karadayı Ergin H, Alışır S, Aksoy Z: Kronik hemodiyaliz hastaları
ile periton diyalizi hastalarının klasik koroner risk faktörleri ve
homosistein düzeyleri açısından karşılaştırılması. İstanbul Tıp
Fakültesi Mecmuası 2004; 67(2): 1-5
7. Mastalerz-Migas A, Reksa D, Pokorski M, Steciwko A, Muszyńska
A, Bunio A, Drobnik J, Pokorna-Kałwak D: Comparıson of a statin
vs. hypolipemic diet on the oxidant status in hemodialyzed patients
with chronic renal failure. J Physiol Pharmacol 2007; 58: 363-370
8. Perunicic-Pekovic GB, Pliesa SI, Rasic ZR, Stankovic SD, Ilic MN:
Inflammatory markers, nutritional paremeters and polyunsaturated
fatty acids in hemodialysis patients. Med Pregl 2007; 60: 43-47
9. Rubanyi GM: The role of endothelium in cardiovascular homeostasis
and diseases. J Cardiovasc Pharmacol 1993; 22: 1-14
10. Önder MR, Barutcuoğlu B. İçinde: Önder MR, Barutcuoğlu B (ed).
Endotel Dergisi 2005; Ocak: 9-17
11. Borawski J, Naumnik B, Pawlak K, Mysliwiec M: Endothelial
dysfunction marker von Willebrand factor antigen in hemodialysis
patients: Associations with pre-dialysis blood pressure and the acute
phase response. Nephrol Dial Transplant 2001; 16: 1442-1447
12. Landray MJ, Wheeler DC, Lip GY, Newman DJ, Blann AD, McGlynn
FJ, Ball S, Townend JN, Baigent C: Inflammation, endothelial
dysfunction and platelet activation in patients with chronic kidney
disease: The chronic renal impairment in Birmingham (CRIB)
study. Am J Kidney Dis 2004; 43: 244-253
13. Sniderman AD, Solhpour A, Williams K, Sloand JA: Cardiovascular
death in dialysis patients: Lessons we can learn from AURORA.
Clin J Am Soc Nephrol 2010; 5: 335-340
14. Chan KE, Thadhani R, Lazarus JM, Hakim RM: Modeling the
4D Study: Statins and cardiovascular outcomes in long-term
hemodialysis patients with diabetes. Clin J Am Soc Nephrol 2010;
5: 856-866
15. Campese VM, Park J: HMG-CoA reductase inhibitors and the
kidney. Kidney Int 2007; 71(12): 1215-1222
155
Özkurt S et al : Evaluation of Pleiotropic Effects of Statins in
Chronic Renal Failure Patients
Türk N efroloji D iyaliz ve Transplantasyon D ergisi
Turkish Nephrology, Dialysis and Transplantation Journal
Turk Neph Dial Transpl 2011; 20 (2): 150-155
16. Navarro JF, Mora C, Muro M, Garcia-Idoate G: Effects of
atorvastatin on lipid profile and non traditional cardiovascular risk
factors in diabetic patients on hemodialysis. Nephron Clin Pract
2003; 95(4): 125-135
17. Joy MS, Dornbrook-Lavender KA, Chin H, Hogan SL, Denu-
Ciocca C: Effects of atorvastatin on Lp(a) and lipoprotein profiles
in hemodialysis patients. Ann Pharmacother 2008; 42(1): 9-15
18. Davignon J, Jacob RF, Mason RP: The antioxidant effect of statins.
Coron Artery Dis 2004; 15(5): 251-258
19. van den Akker JM, Bredie SJ, Diepenveen SH, van Tits LJ,
Stalenhoef AF, van Leusen R: Atorvastatin and simvastatin in
patients on hemodialysis:effects on lipoproteins, C-reactive protein
and in vivo oxidized LDL. J Nephrol 2003; 16(2): 238-244
20. Boaz M, Matas Z, Biro A, Katzir Z, Green M, Fainaru M, Smetana
S: Serum malondialdehyde and prevalent cardiovascular disease in
hemodialysis. Kidney Int 1999; 56:1078-1083
21. Castro PF, Miranda R, Verdejo HE, Greig D, Gabrielli LA, Alcaino
H, Chiong M, Bustos C, Garcia L, Mellado R, Vukasovic JL, Godoy
I, Lavandero S: Pleiotropic effects of atorvastatin in heart failure:
Role in oxidative stres,inflammation, endothelial function and
exercise capacity. J Heart Lung Transplant 2008; 27(4): 435-441
22. Chang JW, Yang WS, Min WK, Lee SK, Park JS, Kim SB: Effects
of simvastatin on high-sensitivity C-reactive protein and serum
albumin in hemodialysis patients. Am J Kidney Dis 2002; 39(6):
1213-1217
23. Mason RP, Walter MF, Jacob RF: Effects of HMG-CoA reductase
inhibitors on endothelial function: Role of microdomains and
oxidative stres. Circulation 2004; 109: 1134-1141
24. Malyszko J, Malyszko JS, Brzosko S, Pawlak K, Mysliwiec M:
Effects of fluvastatin on homocysteine and serum lipids in kidney
allograft recipiens. Ann Transplant 2002; 7(1): 52-54
25. Dejanov P, Polenaković M, Oncevski A, Sikole A, Dejanova B,
Panov S, Kostovska S: The role of the Von Willebrand factor in
Renal diseases and hemodialysis patients. Prilozi 2004; 25(1-2):
5-15
26. Tekin A, Tekin G, Guzelsoy D, Kaya A, Gurel CV, Yigit Z, Ulutin
T: Effect of atorvastatin (10 mg) on hemostatic and ınflammatory
parameters in hyperlipidemic patients with angiographically proven
coronary artery disease. Am J Cardiol 2004; 94: 206-209
27. Asberg A, Hartmann A, Fjeldsa E, Holdaas H: Atorvastatin improves
endothelial function in renal-transplant recipients. Nephron Dial
Transplant 2001; 16: 1920-1924
28. Kaysen GA: The microinflammatory state in uremia: Causes and
potential consequences. J Am Soc Nephrol 2001; 12(7): 1549-1557
29. İkejiri A, Hirano T, Murayama S, Yoshino G, Gushiken N, Hyodo
T, Taira T, Adachi M: Effects of atorvastatin on triglyceride-rich
lipoproteins, low-density lipoprotein subclass, and C-reactive protein
in hemodialysis patients. Metabolism 2004; 53(9): 1113-1117
30. Goicoechea M, de Vinuesa SG, Lahera V, Cachofeiro V, Gómez-
Campderá F, Vega A, Abad S, Luño J: Effects of atorvastatin on
inflammatory and fibrinolytic parameters in patients with chronic
kidney disease. J Am Soc Nephrol 2006; 17: 231-235
31. Li JJ, Chen XJ: Simvastatin inhibits interleukin-6 release in human
monocytes stimulated by C-reactive protein and lipopolysaccharide.
Coron Artery Dis 2003; 14(4): 329-334
32. Kadikoylu G, Yukselen V, Yavasoglu, Bolaman Z: Hemostatic
effects of atorvastatin versus simvastatin. Ann Pharmacother 2003;
37: 478-484

Thank you for copying data from http://www.arastirmax.com